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      Postpregnancy Glycemic Control and Weight Changes in Type 1 Diabetic Women

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          Abstract

          OBJECTIVE

          Pregnancy in type 1 diabetes requires excellent glycemic control. Most pregnant type 1 diabetic women achieve normoglycemia; however, there is scarce data on their postdelivery characteristics. We aimed to examine postpregnancy glycemic control and weight changes in type 1 diabetes.

          RESEARCH DESIGN AND METHODS

          We identified and followed (median 20 months) 254 women with singleton pregnancies receiving postdelivery medical care at a single institution.

          RESULTS

          Study subjects were 28.3 ± 4.7 years of age (mean ± SD), with a diabetes duration of 12.0 ± 7.7 years. Mean A1C before conception was 6.9 ± 1.4%, and preconception weight and BMI were 64.4 ± 10.0 kg and 23.9 ± 3.3 kg/m 2, respectively. Mean A1C decreased during pregnancy, reaching 5.7 ± 0.8% in the third trimester. We observed a mean weight gain of 14.4 ± 6.5 kg during pregnancy. Within 6 months after delivery, A1C increased by 0.8% ( P < 0.0001) compared with the last trimester, and body weight and BMI were 4.4 kg and 2.5 kg/m 2 higher ( P < 0.0001) compared with the preconception baseline. A1C further deteriorated by 0.8% until the end of follow-up. For women in the “pregnancy planning” program ( n = 117), A1C >12 months after delivery was worse compared with before conception (7.1 vs. 6.5%, P = 0.0018), whereas in women with unplanned pregnancies, it was similar to the pregestational levels (7.3 vs.7.4%, P = 0.59). Weight and BMI in the entire study group did not return to prepregnancy levels and were 2.5 kg ( P = 0.0079) and 0.9 kg/m 2 higher ( P = 0.0058).

          CONCLUSIONS

          In this clinical observation, type 1 diabetic women showed postpregnancy deterioration in glycemic control and were unable to return to prepregnancy weight. Type 1 diabetic women seem to require special attention after delivery to meet therapeutic targets.

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          Author and article information

          Journal
          Diabetes Care
          Diabetes Care
          diacare
          dcare
          Diabetes Care
          Diabetes Care
          American Diabetes Association
          0149-5992
          1935-5548
          May 2013
          13 April 2013
          : 36
          : 5
          : 1083-1087
          Affiliations
          [1] 1University Hospital, Krakow, Poland
          [2] 2Section on Genetics and Epidemiology, Joslin Diabetes Center, Boston, Massachusetts
          [3] 3Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
          [4] 4Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
          Author notes
          Corresponding author: Maciej T. Malecki, malecki_malecki@ 123456yahoo.cm .
          Article
          1340
          10.2337/dc12-1340
          3631857
          23250804
          6f521c2e-ec49-4631-a8bf-9b4b52af9884
          © 2013 by the American Diabetes Association.

          Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

          History
          : 7 July 2012
          : 18 October 2012
          Page count
          Pages: 5
          Categories
          Original Research
          Clinical Care/Education/Nutrition/Psychosocial Research

          Endocrinology & Diabetes
          Endocrinology & Diabetes

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